Assessment of the financial gaps in cardiothoracic surgery in Africa.

Abstract

Objectives: This study identified the challenges to financing cardiothoracic surgical care in Africa, highlighting the present state of funding and proffering probable solutions to adequate and effective funding in the region.

Methods: In a literature review, the authors elaborated key points, such as areas of financial funding in cardiothoracic surgery; barriers to appropriate allocation of financial resources for cardiothoracic surgery in Africa; and the needs and available resources for cardiothoracic surgery in Africa. Multiple search engines and databases were used, including but not limited to PubMed, Medline, Cochrane, Scopus and Google Scholar. Sixty articles were identified, and 50 of the 60 were used for this review.

Results: Operations to treat cardiovascular and thoracic diseases performed on the African continent are known to be expensive. They also tend to result in significant morbidity and mortality among the affected individuals because payment is largely out of pocket and the coverage by health insurance providers is low. The establishment of cardiothoracic surgical centres and the delivery of cardiothoracic surgical care are expensive endeavours that limit access to care of patients without comprehensive health insurance or philanthropic support. These poor outcomes are attributed mainly to inadequate funding.

Conclusions: We therefore have recommended advocating for increased funding and for support of policies designed to support the prioritization of cardiothoracic care within national and regional healthcare agendas in order to include cardiothoracic surgery in global and national healthcare plans. Non-governmental organizations and major industries (foreign and local) should be encouraged to invest substantial funds in building and developing cardiothoracic surgery centres in Africa.